Childhood Outcome After In Utero ZIKV Exposure

子宫内 ZIKV 暴露后的童年结局

• 批准号: 10261577
• 负责人: Sarah Beth Mulkey
• 金额: $ 70万
• 依托单位: CHILDREN'S RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-10 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10261577
• 关键词: 7 year old; Address; Affect; Age; Age-Months; Assessment tool; Award; Behavior; Birth; Brain; Brazil; Caribbean region; Caring; Centers for Disease Control and Prevention (U.S.); Cephalic; Child; Child Development; Child Health; Childhood; Clinical; Collaborations; Colombia; Colombian; Communicable Diseases; Complex; Data; Dedications; Development; Developmental Delay Disorders; Disease Outbreaks; Educational Intervention; Emigrations; Epidemic; Evaluation; Exposure to; Family; Future; Goals; Guidelines; Health Policy; Hearing; Image; Individual; Infant; Injury; International; Intervention; Knowledge; Life; Location; Magnetic Resonance Imaging; Manuscripts; Measures; Mission; Mothers; Motor; Neonatal; Neurodevelopmental Impairment; Neurologic; Neurological outcome; Neuropsychology; Outcome; Pediatric Neurology; Perinatal Exposure; Phenotype; Pregnancy; Pregnant Women; Provider; Public Health; Published Comment; Publishing; Questionnaires; Readiness; Research; Rest; Risk; School-Age Population; Shapes; Structure; System; Testing; Therapeutic Intervention; Time; Travel; Ultrasonography; United States; United States National Institutes of Health; United States Virgin Islands; Vascular Diseases; Visual impairment; Washington; Work; ZIKA; ZIKV infection; Zika Virus; authority; brain abnormalities; care providers; cohort; congenital zika syndrome; design; executive function; fetal; follow-up; hearing impairment; improved; in utero; infancy; innovation; medical specialties; multimodality; neurodevelopment; neuroimaging; novel; postnatal; prenatal; prenatal exposure; programs; quantitative imaging; radiologist

PROJECT SUMMARY Clinically normal children exposed to Zika-virus (ZIKV) in utero may evidence abnormal neurodevelopment during the first few years of life even in the absence of the severe phenotype of congenital Zika syndrome (CZS). This is an important problem because the majority of children with in utero ZIKV exposure do not develop CZS but are at risk for neurodevelopmental abnormalities as they mature. The risk for neurodevelopmental impairments at school age in children with in utero ZIKV exposure, who do not have CZS, is not known because children have neither reached nor been studied at this critical age. The long-term goal is to recognize the spectrum of neurologic outcomes for children exposed to ZIKV in utero, which will enable appropriate follow-up guidelines, educational interventions, and therapies to support all children exposed to ZIKV. The objective of this application is to identify school age abnormalities in neurodevelopment and the domains affected and to evaluate for brain structural and functional differences among children in Colombia and in the US with ZIKV exposure in utero who do not have CZS. Guided by strong preliminary data, we will test two specific hypotheses: 1) that executive and motor function will be negatively impacted in ZIKV-exposed children compared to controls; and 2) that quantitative imaging will find structural and functional brain differences between ZIKV-exposed children and controls. The children will be followed at age 5 and 7 years using a specifically designed set of neurodevelopmental assessment tools and quantitative structural and functional neuroimaging. Neurodevelopment will be assessed by an approach utilizing validated questionnaires and child assessments that measure executive function, behavior, motor function, and intellectual ability. The advanced brain MRI will provide a multimodal assessment of brain structure and function. The approach is innovative because of access to two uniquely well characterized cohorts, one from the Caribbean coast of Colombia who had sequential fetal and neonatal neuroimaging and had early neurodevelopmental evaluations and a cohort from a congenital Zika program in the United States with exposure by travel or emigration. The proposed research is significant, because it will address a key question in child health by focusing on neurodevelopmental abnormalities in children following in utero ZIKV exposure that can manifest at school age. Ultimately, such knowledge has the potential to immediately inform the development of guidelines for neuropsychological and imaging assessment at school age for children with in utero exposure to ZIKV. Completion of the aims will improve identification of abnormal neurologic outcomes in children who had exposure to ZIKV in utero. The knowledge to be gained from this work is essential to be done now and is important to families, care providers, public health policy authorities, and federal agencies. It may be also applicable to future congenital infectious epidemics and potentially other perinatal exposures.

项目摘要 子宫内暴露于寨卡病毒（ZIKV）的临床正常儿童可能证据表明神经发育异常 在生命的头几年，即使在缺乏先天性寨卡综合症的严重表型的情况下 （CZS）。这是一个重要的问题，因为大多数有子宫zikv暴露的儿童都不 开发CZ，但在成熟时有神经发育异常的风险。风险 没有CZS的子宫zikv暴露儿童的学龄前儿童的神经发育障碍， 之所以不知道，是因为在这个关键年龄既没有到达也没有被研究过。长期目标是 认识到暴露于子宫里ZIKV的儿童的神经系统结局的范围，这将使 适当的后续指南，教育干预措施和疗法，以支持所有接触的儿童 zikv。该应用的目的是确定神经发育中的学历异常和 影响哥伦比亚儿童的大脑结构和功能差异的领域并评估 在美国没有CZ的子宫内的ZIKV暴露。在强大的初步数据的指导下，我们将 测试两个特定的假设：1）在暴露于ZIKV的情况下，执行和运动功能将受到负面影响 与对照组相比，儿童； 2）定量成像将发现结构和功能性大脑 暴露于ZIKV的儿童和对照之间的差异。儿童将在5岁和7岁时跟随 使用一组专门设计的神经发育评估工具和定量结构和 功能性神经影像学。神经发育将通过使用经过验证的问卷进行评估 以及衡量执行功能，行为，运动功能和智力能力的儿童评估。这 晚期大脑MRI将提供大脑结构和功能的多模式评估。方法是 创新性是因为获得了两个独特特征的人群，一个来自加勒比海沿岸 具有顺序胎儿和新生儿神经影像学，并具有早期神经发育评估的哥伦比亚 以及来自美国先天性寨卡病毒计划的队列，旅行或移民接触。这 拟议的研究很重要，因为它将通过关注儿童健康的关键问题 在子宫zikv暴露后，儿童的神经发育异常，可以在学校表现出来 年龄。最终，这种知识有可能立即告知制定准则的准则 在大学时代的儿童时代，在ZIKV暴露于子宫内的儿童时代的神经心理学和影像学评估。 目的的完成将改善对患有儿童的异常神经系统结局的识别 在子宫内暴露于ZIKV。从这项工作中获得的知识必须现在完成，并且是 对家庭，护理提供者，公共卫生政策当局和联邦机构很重要。也可能是 适用于未来的先天性感染流行病和可能其他围产期暴露。